Tracking Non-Bubble Travelers to Nova Scotia

Any person traveling from outside Atlantic Canada who enters Nova Scotia must self-isolate or
self-quarantine for 14 days to help prevent the spread of COVID-19. This is law under the Health
Protection Act order currently in effect.
Learn what self-isolation or self-quarantine means in Nova Scotia and familiarize yourself with
our public health directives before you travel.
To enter Nova Scotia, everyone outside the bubble must complete this form in advance so that provincial
government officials can confirm that you are following the law. You can either email the form to
border@novascotia.ca and show proof on an electronic device at the border that you have completed
and submitted the form OR present a printed copy of the completed form at the border.
Also be prepared to show valid ID that confirms your residency.

Identification
Primary Contact Name (first, last) Province of Residency

Address Licence Plate (if applicable)

City Province/Territory Postal Code Phone

Passengers
Name (first, last) Name (first, last)

Name (first, last) Name (first, last)

Entry Details
Date of Entry Entry Point
Amherst land border Halifax airport North Sydney ferry
Sydney airport Digby ferry

Resident Verification type:

Drivers’ license Government identification card Bank statement w/ permanent home address
Health card Utility bill w/ permanent home address
Where are you coming from?

Where are you going in NS? Duration of visit

Contact Location and Information during self-isolation or self-quarantine in Nova Scotia

Civic address Phone number you can
be reached 24/7

Rev 06Jul2020
Tracking Non-Bubble Travelers to Nova Scotia
Self-declaration

This collection and use of information is authorized by sections 8, 15 and 50 of the

Health Protection Act.
The travellers listed on this form must make the following declarations:
I am 18 years of age or older.
I understand that I must self-isolate or self-quarantine for a period of 14 days upon
arrival if I have travelled outside of Atlantic Canada in the previous 14 days.
I declare that the information given on this form is complete, correct and fully discloses
everything concerning my eligibility to travel to NS. I understand that it is an offence to
knowingly provide false or misleading information, either orally or in writing, to a public health
official under the NS Health Protection Act for which I may be fined $1,000.00 per occurrence.
I agree to the disclaimers and privacy statements

Signature Date

Rev 06Jul2020